The Top 5 Medicare Mistakes

Open Enrollment is October 15 – December 7 and let’s be honest, it’s…a lot. From confusing plan names to being bombarded by advertising, it’s no wonder people feel overwhelmed. Read the Top 5 Medicare Mistakes to get prepared for Medicare Open Enrollment.

Mistake #1 – Assuming Employer or Group Coverage Means You Have No Need for Medicare

A common mistake many people make is assuming they don’t need Medicare if they already have employer or group health coverage. While it may feel like you’re covered, overlooking Medicare could mean missing out on more comprehensive, and often more cost-effective, benefits.

Here’s why it’s worth a second look:

• Employer plans often come with limitations like high deductibles, copays, or coinsurance that Medicare could help reduce.
• Network restrictions in group plans can limit your choice of doctors and hospitals. Medicare plans might offer broader access.
• Medicare can be customized. This gives you the flexibility to choose a plan that fits your specific health needs and budget. This could be less expensive for you.

Even if you’re currently insured through work or a group, it’s smart to compare. Medicare may offer better coverage or savings in the long run, especially when it comes to managing ongoing or complex healthcare needs.

Mistake #2 – Relying On Non- Professional Guidance

It’s totally normal to ask friends, family, or coworkers for Medicare advice, but relying on non-professionals is one of the most common (and costly) mistakes people make.

Why? Because Medicare isn’t one-size-fits-all. What worked great for your cousin or neighbor may not suit your specific health needs, budget, or lifestyle. Plus you need to know which plans your specific doctors take.

Here’s how working with a professional Medicare advisor can help:

• Tailored recommendations based on your unique health situation and current coverage.
• Understanding your options—including plan costs, benefits, and provider networks.
• They stay up to date on the latest Medicare changes, so you don’t have to.
• They can communicate with your healthcare providers to make sure they will continue accept your specific plan.

Medicare is complicated, and the right plan can have a big impact on your health and wallet.

Mistake #3 – Not Fully Understanding Medicare Advantage vs. Medicare Supplement Plans

The differences between Medicare Advantage and Medicare Supplement (Medigap) plans can be confusing, especially during your initial enrollment period when you’re guaranteed approval. But don’t worry—here’s a simplified breakdown to help you make sense of it all.

Medicare Advantage (Part C):

• All-in-one alternative to Original Medicare
• Offered by private insurance companies
• Often includes extras like prescription drugs, dental, vision & hearing
• Requires using the plan’s network of doctors and hospitals

Medicare Supplement (Medigap):

• Works alongside Original Medicare
• Covers costs Medicare doesn’t (deductibles, copays, coinsurance)
• No network restrictions—you can see any doctor or hospital that accepts Medicare
• Doesn’t typically include prescription drug coverage (you’d need a separate Part D plan)

The key is to match the plan to your personal health needs, budget, and doctor preferences. Comparing the pros and cons of each gives you the confidence to choose the coverage that works best for you without the confusion.

Mistake #4 – Brand Loyalty

 While it’s easy to stick with a familiar insurance company, each provider offers different plans, benefits, and costs. By comparing options from multiple insurers, you increase your chances of finding coverage that fits both your needs and budget.

Be sure to review:

• Monthly premiums and deductibles
• Copayments and out-of-pocket costs
• Coverage for services important to you
• Whether your preferred doctors accept the plan

Keeping an open mind can lead to better care—and savings.

Mistake #5 – Not Reviewing Your Options Each Year

If you don’t compare plans, you could end up paying more, receiving less coverage -or both!- over the years.

As insurance plans and your personal health needs change each year, it’s up to you to make sure your plan still fits. Premiums, copays, covered services, and networks might also shift so staying in contact with your Medicare advisor ensures you’re up to date on plan coverage. If you need to switch plans you’ll want to be ready during the open enrollment period.

To avoid overpaying or underinsuring yourself:

• Review your Medicare plan annually
• Check for any updates from your insurance company
• Note changes in costs, coverage, and provider networks
• Compare options based on your current needs and budget

While your advisor will keep you posted on plan changes, a quick yearly check-in for you to share any health changes can help you avoid surprises and stay fully covered.

For the full breakdown of Medicare benefits, read the Medicare & You Handbook at Medicare.gov. And when you’re ready to explore plans, we can help you find a Medicare expert to lay out all of your local options at no cost to you.